Aim: To analyse the management of complications arising from the insertion of penile prostheses. Patients and Methods: The notes of 447 men who had 504 penile prostheses implanted between August 1975 and December 2000 were reviewed. The mean follow-up was 50 months (range 1-297). The management and outcome of patients with complications was recorded. Results: 102 patients experienced complications: 8 developed a penoscrotal haematoma all managed conservatively; 25 had a superficial wound infection, all treated with antibiotics and none required removal of the prosthesis.;33 had delayed deep infection and all required prosthesis removal. Of the prostheses which became infected ,4,7%, (17) were malleable, 16,4% (10) were 3-piece inflatable and 24% (6) were self-contained; 13 went into urinary retention post-operatively; all subsequently passed a trial without catheter; 16 developed erosion of the prosthesis (9 distally, 4 urethrally, 3 proximally): all had their prosthesis removed and replaced. With regard to cavemous erosion, 11 prostheses were malleable (4,4%), 4 were 3-piece inflatable (6,6%) and one was self-contained (4%). The other reasons for removal of the prosthesis were: the prosthesis was too short, the reservoir was not in piace or mechanical failure. There was no correlation between diabetes and the rate of prosthesis infection. The aetiology of erectile dysfunction was related to diabetes mellitus in 27.3% (122 patients). Diabetes was associated with 36% (12 patients) whose prostheses became infected whereas 64% (21 patients) were non-diabetics. Therefore only 9.8% (12 of 122) diabetic patients who underwent penile prosthesis surgery had their implant infected. Conclusions: Diabetes does not predispose the patient to a higher risk of prosthesis -related infection. However, the type of prosthesis (self-contained or 3 piece) is associated with a higher risk of infection. Penoscrotal haematoma without the evidence of infection may be managed without the insertion of a drain. Deep infection and cavernous erosion should be treated by prosthesis removal whereas superficial infection is adequately managed with broad-spectrum antibiotics

THE MANAGEMENT OF COMPLICATIONS OF PENILE PROSTHESIS INSERTION / A. Minervini; J. Kalsi; S. Minhas; R. Rees; D. Ralph; J. Pryor. - In: INTERNATIONAL JOURNAL OF IMPOTENCE RESEARCH. - ISSN 0955-9930. - STAMPA. - 14- suppl.3:(2002), pp. 109-110. (Intervento presentato al convegno 10th World Congress of the International Society fo Sexual and Impotence Research tenutosi a Montreal- Canadà nel 22-26 settembre).

THE MANAGEMENT OF COMPLICATIONS OF PENILE PROSTHESIS INSERTION

MINERVINI, ANDREA;
2002

Abstract

Aim: To analyse the management of complications arising from the insertion of penile prostheses. Patients and Methods: The notes of 447 men who had 504 penile prostheses implanted between August 1975 and December 2000 were reviewed. The mean follow-up was 50 months (range 1-297). The management and outcome of patients with complications was recorded. Results: 102 patients experienced complications: 8 developed a penoscrotal haematoma all managed conservatively; 25 had a superficial wound infection, all treated with antibiotics and none required removal of the prosthesis.;33 had delayed deep infection and all required prosthesis removal. Of the prostheses which became infected ,4,7%, (17) were malleable, 16,4% (10) were 3-piece inflatable and 24% (6) were self-contained; 13 went into urinary retention post-operatively; all subsequently passed a trial without catheter; 16 developed erosion of the prosthesis (9 distally, 4 urethrally, 3 proximally): all had their prosthesis removed and replaced. With regard to cavemous erosion, 11 prostheses were malleable (4,4%), 4 were 3-piece inflatable (6,6%) and one was self-contained (4%). The other reasons for removal of the prosthesis were: the prosthesis was too short, the reservoir was not in piace or mechanical failure. There was no correlation between diabetes and the rate of prosthesis infection. The aetiology of erectile dysfunction was related to diabetes mellitus in 27.3% (122 patients). Diabetes was associated with 36% (12 patients) whose prostheses became infected whereas 64% (21 patients) were non-diabetics. Therefore only 9.8% (12 of 122) diabetic patients who underwent penile prosthesis surgery had their implant infected. Conclusions: Diabetes does not predispose the patient to a higher risk of prosthesis -related infection. However, the type of prosthesis (self-contained or 3 piece) is associated with a higher risk of infection. Penoscrotal haematoma without the evidence of infection may be managed without the insertion of a drain. Deep infection and cavernous erosion should be treated by prosthesis removal whereas superficial infection is adequately managed with broad-spectrum antibiotics
2002
International Journal of Impotence Research
10th World Congress of the International Society fo Sexual and Impotence Research
Montreal- Canadà
A. Minervini; J. Kalsi; S. Minhas; R. Rees; D. Ralph; J. Pryor
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/686058
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